Thank you for your gift to The Mother Road Ride 2012, Presented by Sam's Club.

Gift Information

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Select A Gift Amount:Required

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$200.00

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$150.00

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$100.00

Select A Gift Amount:

$75.00

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$50.00

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$25.00

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*

Select A Gift Amount:Required

Select A Gift Amount:

$200.00

$150.00

$100.00

$75.00

$50.00

$25.00

Enter an Amount
Enter amount.

Yes, make this an anonymous gift.

Recognition Name:This will be used for public recognition (example, John Smith or The Smith Family).

This will be used for public recognition (example, John Smith or The Smith Family).

Check this option if the amount of your donation can be displayed publicly in fundraising lists.

Yes, you can display the amount of my donation publicly

Check this option if the amount of your donation can be displayed publicly in fundraising lists.

Personal Note:The person that you are donating on behalf of will receive this note.

The person that you are donating on behalf of will receive this note.

Matching Gifts

Your company may match your donation to the National Multiple Sclerosis Society. Use the search box below to find out if your employer will match your gift. In addition to locating your employer in the search, you will also need to contact your company's HR department to complete the necessary paperwork to have your gift matched. Selecting your employer here DOES NOT complete the matching gift process. (If you do not find your employer in the list, please contact your HR department to inquire about the possibility of having it added.)